Risk of ultrasound-detected neonatal brain abnormalities in intrauterine growth-restricted fetuses born between 28 and 34 weeks' gestation: relationship with gestational age at birth and fetal Doppler parameters

Abstract

Objective To estimate the value of gestational age at birth and fetal Doppler parameters in predicting the risk of neonatal cranial abnormalities in intrauterine growth-restricted (IUGR) fetuses born between 28 and 34 weeks' gestation. Methods

Predictors of Cranial Ultrasound Abnormalities in Intrauterine Growth-Restricted Fetuses Born between 28 and 34 Weeks of Gestation: A Prospective Cohort Study

“…According to this study, GA as an independent variable was a strong predictor of IVH, PVL, BGLs, and any CUA, indicating that a 1-week increase in GA was accompanied by a significant decrease in the risk of the mentioned abnormalities. Regardless of IUGR, lower GA was an important predictor of NBAs, which was in line with the results of previous studies [13,21]. Considering that some neonates may not have IVH during the first days after birth, but after admission to the neonatal intensive care unit following postbirth events, such as respiratory problems and respiratory distress syndrome in particular, have been recognized as important risk factors in the development of germinal matrix hemorrhage-IVH [22,23], we wanted to examine the course of IVH in these infants over time, similar to Cruz-Martinez et al [13].…”

“…However, there is some controversy about the value of Doppler parameters in accurately predicting the risk of adverse neurological outcomes [9][10][11][12]. While the values of fetal Doppler parameters were shown to predict NBAs in one study [13], insufficient evidence is available to determine the value of these parameters for predicting neurological outcomes. The aim of this study was to assess the value of Doppler parameters in predicting neurological outcomes among fetuses at 28-34 weeks of gestation.…”

“…IVH was classified according to the criteria described by Volpe [17]. BGL was diagnosed if an echodensity or an echolucency was seen at any time within the basal ganglia area [13].…”

Brain-Sparing in Intrauterine Growth Restriction: Considerations for the Neonatologist

“…Two recent studies have demonstrated a positive association between prenatal signs of brain-sparing and ICH [77,78]. In their large prospective study of 90 IUGR subjects, Cruz-Martinez et al [77] found that IUGR neonates with an abnormal prenatal MCA-PI presented with ICH significantly more often than their non-brain-sparing counterparts and controls.…”

“…In their large prospective study of 90 IUGR subjects, Cruz-Martinez et al [77] found that IUGR neonates with an abnormal prenatal MCA-PI presented with ICH significantly more often than their non-brain-sparing counterparts and controls. In the study by Ertan et al [78], although prenatal Doppler data were available for only a subgroup of neonates, the MCA-RI appeared to be lower in their ICH group.…”